B.C. man waits three years for hernia surgery

Vancouver flamenco dancer/teacher Oscar Nieto has waited nearly three years for hernia surgery that was diagnosed four years ago.

That’s 2.5 years too long to wait, according to the Vancouver General Hospital’s own standards and those of the Ministry of Health.

“The target for this type of surgery is 12 weeks,” said VGH spokesman Gavin Wilson.

“This patient obviously waited too long and we understand his frustration,” he told The Vancouver Sun. “When you brought this to our attention, we started to work with the surgeon to find a way to get this patient’s surgery completed as soon as possible.”

According to a study in the B.C. Medical Journal last year, waiting times for hernia surgery in four health regions across B.C. were consistently higher than they were in four other provinces providing similar measurements — Ontario, Alberta, New Brunswick and Nova Scotia. In B.C., 90 per cent of patients got their hernia surgery in 29.7 to 36 weeks. In the other provinces, the waiting times were 15.9 to 28 weeks.

The study by Dr. Hamish Hwang and Dr. Ahmer Karimuddin concluded that a third of the cases don’t meet benchmark times because of inadequate resources, including too few surgeons with too little access to operating room time and space.

At one point last year, Nieto was prepped and ready to go into the operating room when his case suddenly got bumped by one considered more urgent, Wilson said. He put his clothes back on and never heard from his doctor again.

Nieto said Wednesday that telling The Vancouver Sun about how much the delay was hurting his career, and then having a reporter delve into the matter, clearly helped his case because he got a phone call soon after telling him that he finally had a surgery date in early June. He said he’s grateful because the hernia has affected his ability to dance and teach because of the pain he experiences when he attempts certain moves and positions.

Wilson agreed that the matter needed to be brought to the attention of hospital administrators, not to mention the surgeon, Dr. Adam Meneghetti.

Nieto developed his hernia in 2009 after having surgery to remove a tumour in his colon. He has been cancer-free for six years and credits Meneghetti with saving his life.

There are about 1,000 adult individuals booked and waiting for hernia surgery at hospitals in the Vancouver Coastal Health region, and 4,126 throughout B.C.

Wilson said 72 per cent of patients are treated within the 12-week time target. At VGH, 50 per cent of abdominal hernia repairs are treated within 20.4 weeks and 90 per cent within 44.8 weeks. Having the surgery done at the University of B.C. Hospital can mean far shorter waits, but those are also the least complicated cases.

While there are 727 patients, as of now, who have been waiting at least a year for all types of elective surgery (not just hernias), just over a year ago that number stood at 2,200, Wilson said, so progress is being made.

By this time next year, the goal is to ensure that 80 per cent of patients have their surgery within the benchmark time and 85 per cent by March 2016.

“We also want to ensure zero patients wait more than 52 weeks for surgery,” Wilson said, while admitting that Nieto is one of four patients who have been waiting more than a year for the type of hernia repair he needs.

To meet the targets, the health region has to get better at maximizing operating room space, Wilson said. Allocating OR time between surgeons to balance capacity and demand is also a major challenge.

Health regions can purchase OR time at private facilities for simpler procedures but hernia operations are not included in the contracted-out cases, he said.

Nieto said he doesn’t want to cast blame on his surgeon or anyone else because the system seems to be clearly overwhelmed. “I think they are caught between a rock and a hard place.

“But my issue is that this hernia has affected my balance, my posture and my core strength. This is my livelihood. I have to work to meet my financial obligations.”

Although Nieto says he doesn’t like to “badger” doctors, Wilson said sometimes patients have to be a little more assertive.

“We encourage a patient with a concern about their wait time to discuss it with their surgeon. If they’re still unsatisfied, they can contact the patient relations office at the hospital where their case has been booked.”

Patients can also complain about such matters to the Patient Care Quality offices in each health region.

Hernia repair surgery is one of the most common surgical procedures to fix the protrusion of organs or tissue through an abnormal opening. At least 12,000 such cases are done each year in B.C.

Typically, hernias occur when a piece of intestine slips through the abdominal wall. They can occur around the naval, where Nieto has his hernia, in the groin (inguinal hernia), or any place where a patient has had a previous surgical incision.

Waiting times in weeks for 90 per cent of patients, by province and by B.C. healthy authority, for hernia surgeries between Aug. 1 and Oct. 31, 2012

B.C. 32.2

Vancouver Coastal Health 35.8

Fraser Health 29.7

Interior Health 36.0

Northern Health 18.7

Vancouver Island Health 33.7

Ontario 15.9

Alberta 28

New Brunswick 19.1

Nova Scotia 18.1

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